Somatization
Somatization refers to the process by which psychological distress manifests as physical symptoms. It is a key concept in psychiatry and has been defined differently in major classification systems like the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM).
The ICD describes somatization as recurrent and changing physical symptoms lasting for years, often accompanied by extensive medical investigations and patient resistance to reassurance. Terms like "unexplained somatic complaints" are used in primary care to describe similar cases without implying a psychological cause.
In the DSM, somatization is categorized under somatoform disorders, defined by the presence of multiple, persistent symptoms involving pain and gastrointestinal, sexual, and neurological complaints.
A particulary large proportion of patiens with somatization experience dermathological issues. Specifically in dermathology somatization is described as the phenomenon of experiencing bodily symptoms, most commonly pain and itch, in the absence of a biological cause. Somatization may occur with or without the existence of a dermatological disease. Somatic symptoms can be solely focussed on the skin, with pruritus or discomfort being the most prevalent, or with other symptoms including headache, back pain, exhaustion, gastrointestinal symptoms, chest pain, shortness of breath and paresthesia. There is often a preoccupation with abnormal thoughts, feelings and behaviours. This leads to significant stress and for the affected individual. Disorders presenting with cutaneous somatic symptoms or with somatic overlay in established immunodermatoses, frequently present in both primary and secondary care. Somatic symptom disorders and somatic symptoms and related disorders have been newly categorized in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM‐5) within the last 10 years.
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American psychiatric association (2022). Diagnostic and statistical manual of mental disorders. Fifth edition. Text revision. Dsm-5-tr. American psychiatric association publishing. Retrieved from: https://shorturl.at/G3ur8.
Millington, G. W. M., Shobajo, M. T., Wall, J., & Jafferany, M. (2022). Somatization in dermatology. Skin Health and Disease, 2(4). Retrieved from: https://shorturl.at/NzMyd.
Boerner, K. E.,et al. (2019). Making Sense of “Somatization”: A Systematic Review of its Relationship to Pediatric Pain. Journal of Pediatric Psychology, 45(2), 156–169.Retrieved from: https://shorturl.at/YpT07.